In 2010 then Speaker Nancy Pelosi famously said about the pending ObamaCare legislation, "We have to pass the bill so that you can find out what is in it.”

Now more than 3 ½ years later, much of what we’re finding out is disturbing. The glitches with the web-based Obamacare signup and the cancellation of promised grandfathered insurance policies are today's front page news, but there are numerous other troublesome features, including waste and abuse.

A glaring example is something called the Patient-Centered Outcomes Research Institute (PCORI), which was established in the ObamaCare legislation to ascertain the relative health outcomes, clinical effectiveness, and appropriateness of different medical treatments and services. This is similar to the comparative effectiveness research conducted for decades by governments in countries such as Canada, the UK, Germany and Australia, which assumes that the results will facilitate decisions about what care is appropriate (read: cost-effective).

Bizarrely, Congress established PCORI as a private, non-profit corporation, not as a federal agency, and funded this private corporation with a new federal tax, the "PCORI Fee." PCORI has been generously endowed with what the organization estimates will be a honey pot of 3.5-4.5 billion taxpayer dollars through 2019, without having to get annual appropriations from Congress and without being subject to the usual financial controls imposed on federal agencies. PCORI receives only a cursory annual review by the Comptroller General, who also appoints PCORI's board.

The "PCORI Fee," or tax, is paid to the IRS by insurance companies and employers for everyone who has health coverage. The PCORI Fee for 2013 was $1 per covered person per year; it will rise to $2 each person in 2014; and its further increases will be linked to inflation from 2015 to 2019. For fiscal years 2010-2012, before the new tax went into effect, PCORI received a total of $210 million from the general revenues of the federal government. For 2013 through 2019, each year PCORI will receive the PCORI tax collected plus $150 million from general tax revenues.

The generously funded PCORI bureaucracy has spread its largess across a broad array of health research constituents across the country in almost every state. As of September 2013, PCORI had approved more than $303 million in grants and is on track to commit more than $400 million in research support in 2013. The real value of this comparative effectiveness research for the prevention and treatment of disease will be known only when the results are completed and tested in the real world.

However, a few examples of this year’s multi-million dollar awards raise warning flags. The dubious projects include:

Comparison of Peer Facilitated Support Group and Cognitive Behavioral Therapy for Hoarding Disorder

Impact of Patient Navigators on Health Education and Quality of Life In Formerly Incarcerated Patients

Evaluating the Navajo Community Outreach & Patient Empowerment (COPE) Program

PCORI's funding, which comes without annual government budget reviews, has various health-care researchers, academics, and other stakeholders salivating. That PCORI has made so many generous awards and is anticipated to make many more is a backwards approach for justifying the special tax imposed on Americans’ health coverage to pay for this research. The premise is that PCORI awards a lot of money because the research is useful for patients and will save money in the long run. More likely, the funding will support various health research constituencies and will create a kind of cottage industry of politically correct research projects.

Assuming that PCORI is worthwhile at all, Congress owes us an explanation of why it was established as a private-sector entity rather than using an existing government organization. A veritable alphabet soup of federal agencies already engages in and supports similar comparative effectiveness research. Indeed, comparative effectiveness research activities had already been boosted by the Stimulus Act of 2009, which gave a special appropriation of $1.1 billion to the Agency for Healthcare Research and Quality, the National Institutes of Health, and the Secretary of Health and Human Services. Strangely, Congress requires PCORI to distribute a certain amount of its funds back to the government's Department of Health and Human Services.

PCORI cannot be fixed because its structure and pork are inherently corrupting. Congress should repeal PCORI.

John J. Cohrssen and John S. Hoff are health care attorneys in private practice who have previously served in senior government health care policy positions. Mr. Cohrssen served in senior staff positions in the White House, the Senate and the House of Representatives. Mr. Hoff served in the Department of Health and Human Services as a Deputy Assistant Secretary for Planning and Evaluation.